SuRxgWell: study protocol for a randomized controlled trial of telemedicine-based digital cognitive behavioral intervention for high anxiety and depression among patients undergoing elective hip and knee arthroplasty surgery

The efficacy of auricular acupressure combined with emotional freedom techniques on the postoperative pain and anxiety state of patients with lower limb fractures: A randomized clinical controlled trial

BACKGROUND

Lower limb fractures cause local pain, swelling, ecchymosis, and dysfunction. Clinically, incision and reduction surgery are often employed to treat lower limb fractures. However, postoperative pain can be intense, leading to adverse emotions that hinder subsequent recovery.

METHODS

A total of 99 postoperative patients with lower limb fractures were randomly divided into 3 groups: the control group (routine care, 33 patients), the auricular acupressure group (routine care plus auricular acupressure, 33 patients), and the combined group (routine care, auricular acupressure, and emotional freedom techniques [EFT], 33 patients). Pain levels were measured using the visual analog scale (VAS), and anxiety levels were measured using the self-rating anxiety scale (SAS) at various time points post-intervention. Patient satisfaction with nursing care was also evaluated at the end of the intervention.

RESULTS

The VAS scores in the combined group were significantly lower than those in the auricular acupressure and control groups at 4, 12, 24, and 48 hours post-intervention (P < .05). Additionally, the SAS scores in the combined group were significantly lower than those in the auricular acupressure and control groups at 72 hours post-intervention (P < .05). The combined group also reported significantly higher satisfaction with nursing care compared to the other 2 groups at the end of the intervention (P < .05).

CONCLUSION

Auricular acupressure combined with EFT effectively reduces pain levels, alleviates anxiety, and increases patient satisfaction with nursing care in postoperative patients with lower limb fractures.

Telehealth approaches for improving depression and anxiety among patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

OBJECTIVE

This study aimed to systematically review the efficacy of telehealth approaches in alleviating depressive and anxiety symptoms in patients with chronic obstructive pulmonary disease (COPD) using evidence from randomized controlled trials (RCTs).

METHODS

This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. Databases including PubMed, Embase, Web of Science, and the Cochrane Library were searched for RCTs from database inception to June 2024. All statistical analyses were performed using RevMan 5.3. The standard mean difference (SMD) was used to pool the fixed effects of continuous outcomes.

RESULTS

Seven RCTs comprising 1174 participants were included in this review. The pooled analysis demonstrated that, compared with the control group, telemonitoring significantly affected anxiety among patients with COPD (SMD = -0.12, 95 % confidence interval [CI]: [-0.24, -0.01], p = 0.04), whereas the effect on depression was not significant (SMD = -0.10, 95 % CI: [-0.22, 0.02], p = 0.09).

CONCLUSION

Telemonitoring effectively reduced anxiety in patients with COPD but had no significant effect on depression. The relatively small number of studies suggests that this area of research is still developing. Additional high-quality, enriched, and more widely distributed intervention studies are needed to further assess the effectiveness of telehealth approaches on mental health among patients with COPD.

Evolution of quality of life, anxiety, and depression over time in patients with an abdominal aortic aneurysm approaching the surgical threshold

BACKGROUND

Contrary to the impact of screening, the effect of long-term surveillance on the quality of life of patients with an abdominal aortic aneurysm is not well known. Therefore, the aim of this study was to describe patient-reported outcomes of patients with an abdominal aortic aneurysm approaching the surgical threshold.

METHODS

This multicentre, observational cohort study included patients with an abdominal aortic aneurysm with a maximum aneurysm diameter of greater than or equal to 40 mm. The EuroQol five-dimension five-level questionnaire (range -0.446 to 1, minimal clinically important difference 0.071), the Hospital Anxiety and Depression Scale questionnaire (0-21 points/subscale, minimal clinically important difference 1.7 points), and the short version of the Patient Health Questionnaire (0-6 points) were mailed to patients with an abdominal aortic aneurysm at baseline and after 1 and 2 years or until abdominal aortic aneurysm surgery/death. Linear mixed-effects models were used to describe the evolution of patient-reported outcomes over time and investigate changes attributable to clinical characteristics.

RESULTS

In total, 291 to 294 responses to each questionnaire were available from 124 patients with an abdominal aortic aneurysm, of whom 34 underwent surgery during follow-up. The mean health-related quality of life and anxiety and depression scores over time were 0.781 (95% c.i. 0.749 to 0.814), 4.4 points (95% c.i. 3.9 to 4.9), and 4.6 points (95% c.i. 4.0 to 5.2) respectively. Anxiety and depression scores decreased in patients who underwent surgery with a mean of 2.8 (95% c.i. 1.1 to 4.6) and 2.0 (95% c.i. 0.4 to 3.6) points/year respectively, compared with patients who had not had surgery. Considering the minimal clinically important difference, patients with a primary education alone, compared with a secondary education, had higher or increasing anxiety and depression scores. Patients with a first-degree relative with an abdominal aortic aneurysm had a higher risk of clinical anxiety.

CONCLUSION

Although health-related quality of life, anxiety, and depression remain stable over time on average, anxiety and depression decrease in patients approaching surgery. Patients with a family history of abdominal aortic aneurysm or a primary education alone experience more anxiety and/or depression and thus might benefit from a tailored approach during surveillance.

Osteoarthritis with depression: mapping publication status and exploring hotspots

Depression is a common psychological complication in osteoarthritis (OA) patients, and its incidence gets more and more attention year by year worldwide. This study investigates the association between OA and depression through a bibliometric analysis of published studies. It aims to identify leading authors, institutions, and countries to highlight research hotspots and suggest potential future directions. We collected publications on OA and depression from 1994 to 2024 using the Web of Science Core Collection (WOSCC) database. Bibliographic information, including authorship, country of origin, citation frequency, and visualizations, was generated using VOSviewer, R software, and CiteSpace. A total of 2,342 articles were identified. The United States led in publications with 906 articles, Boston University was the most prolific institution with 56 publications, BMC Musculoskeletal Disorders was the top journal with 71 publications, and Stefania Maggi was the most productive author with 19 publications. The primary research hotspots identified were: "The relationship between depression and OA," "Disability and prevalence," and "Characteristics of older people suffering depression after OA." Predicted future research frontiers include: "Treating depression in OA patients with multimorbidity," "Psychometric properties of instruments for assessing depression and anxiety in OA patients," "Depression or anxiety in patients with surgical intervention," and "Other mental diseases in OA patients." This bibliometric analysis underscores the importance of understanding the link between OA and depressive disorders, potentially guiding new research directions.

Identifying the blue patient: preoperative screening for depression

Preoperative depression is an underappreciated comorbidity that has important implications for postoperative outcomes. Screening for symptoms of depression before surgery can identify patients with or without a previous diagnosis of depression who could benefit from perioperative interventions to improve mood. Preoperative screening programmes are feasible to implement, although care must be taken to ensure that patients who are most likely to benefit are included.

A bibliometric analysis of research on pediatric preoperative anxiety (2007-2022)

Objective

This study aimed to analyze the current state of research on preoperative anxiety in children through CiteSpace, VOSviewer, and the identification of hot spots and frontiers.

Method

Relevant data were retrieved from the Web of Science Core Collection using the search terms children and preoperative anxiety. Data were analyzed using VOSviewer (version 1.6.18), CiteSpace (5.7. R5) software, and Scimago Graphica.

Results

A total of 622 articles were published between 2007 and 2022, with an increasing trend over time. Kain, Zeev N. (13; 2.09%) and Dalhousie University (15; 2.41%) were the most influential authors and most prolific institutions, respectively. The United States (121; 19.45%) was the country with the most publications. Pediatric anesthesia (55; 8.84%) had the most publications. High-frequency keywords were categorized into three themes, including nonpharmacologic interventions for preoperative anxiety in children, preoperative medications, and risk factors for anxiety; of these, "predictor" (38; 2016) and "sedative premedication" (20; 2016) were the most studied keywords over the past 6 years. "Distraction" (67; 2019) and "dexmedetomidine" (65; 2019) have been the main areas of interest in recent years.

Conclusion

Research on preoperative anxiety in children has been the focus of increasing attention over the past fifteen years, with the majority of publications from high-income countries. This review provides a useful perspective for understanding research trends, hot topics, and research gaps in this expanding field.